| NPI | 1063919892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERESE GREEN President 187-051-4938 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2021-05-07 |